Development of a patient-led clinic visit framework: a case study navigating a patient's journey for rheumatology outpatient clinic consultations in England and Wales.

Background: Involving patients and members of the public in healthcare planning is beneficial for many reasons including that the outcomes focus on topics relevant to service users. The National Early Inflammatory Arthritis Audit (NEIAA) aims to improve care quality for patients with inflammatory arthritis.

Case Study: This paper presents a case study detailing how the NEIAA Patient Panel worked with NEIAA governance groups, the National Rheumatoid Arthritis Society and the National Axial Spondyloarthritis Society to co-create an outpatient clinic visit framework for rheumatology professionals.

The "postcode lottery" for the surgical correction of gynaecomastia in NHS England.

Introduction: Action On Plastic Surgery (AOPS) criteria for funding of gynaecomastia surgery are: the patient should be post-pubertal, have a BMI ≤ 25 kg/m(2), endocrine and drug causes and breast cancer should be excluded and the patient should demonstrate psychological distress. We evaluated how NHS funding for gynaecomastia surgery varies between Clinical Commissioning Groups (CCGs) in England and whether there is a "postcode lottery".

Methods: The gynaecomastia surgery policies for 211 CCGs in NHS England were reviewed against the AOPS criteria and grouped according to their funding policies: group 1 (if criteria met, funding approved); group 2, (if criteria met, prior approval required); group 3 (no criteria, individual funding request only) and group 4 (no funding).

Review of three-dimensional (3D) surface imaging for oncoplastic, reconstructive and aesthetic breast surgery.

Three-dimensional surface imaging (3D-SI) is being marketed as a tool in aesthetic breast surgery. It has recently also been studied in the objective evaluation of cosmetic outcome of oncological procedures. The aim of this review is to summarise the use of 3D-SI in oncoplastic, reconstructive and aesthetic breast surgery.

Is there a digital generation gap for e-learning in plastic surgery?

Background: Some authors have claimed that those plastic surgeons born between 1965 and 1979 (generation X, or Gen-X) are more technologically able than those born between 1946 and 1964 (Baby Boomers, or BB). Those born after 1980, which comprise generation Y (Gen-Y), might be the most technologically able and most demanding for electronic learning (e-learning) to support their education and training in plastic surgery. These differences might represent a "digital generation gap" and would have practical and financial implications for the development of e-learning.

Spontaneous cecum perforation following rectus abdominis free flap transfer for isolated lower limb trauma.

A case of a 32-year-old motorcyclist, who sustained an open comminuted fracture of the left tibia and subsequently developed spontaneous cecal perforation following successful fixation of the fracture and reconstruction of the soft tissue defect with a rectus abdominis free flap, is reported. Although benign cecal perforation has been described in patients with thermal burns and blunt trauma of the abdomen or pelvis, our association has not been reported previously in the medical literature. It is important to recognize cecal perforation early as it is associated with a high mortality from peritonitis and septicaemia.

A rare case of adenocarcinoma arising within a duplication cyst of the rectum: curative excision with 9-year follow-up.

This case report is novel in that it describes the successful excision of an adenocarcinoma arising within a rectal duplication cyst without evidence of disease recurrence at 9-years of follow-up.